Her right eye, on the other hand, was already damage. The cloudy cornea had caused blindness and the only available treatment for her was a corneal transplant. The procedure includes removing the cloudy cornea and replacing it with a clear cornea donated through an eye bank. And because of the complexity of this procedure, her doctors advised us to focus on her left eye first before proceed to her right eye.

Until last week when she had her regular checkup, the option of corneal transplant was discussed again and yesterday we were informed that an eye donation was available for her. The doctor then asked if my mom wanted to proceed with the transplantation.  She agreed, so yesterday evening she had a complete examination prior the surgery. She had an ultrasound scan on her right eye, hematology test and EKG monitor. We went home late last night.

Her ophthalmologist said she would perform corneal transplant and cataract surgery at the same time on my mom’s right eye. The surgery date was set this Saturday (March 12th) and she had to be there at 8AM. I already signed the consent form. Unlike previous procedures, this time my mom would be given a general anesthesia and required to stay at the hospital after the surgery so I booked a room for her too.

The doctor also informed us about the risk of this procedure such as rejection of the new cornea and infection, but she said they were treatable. She would also look at my mom’s hematology test result (which will be out later today) before performing the surgery. My mom’s BP readings was high last night 200/100 mm Hg, so the internist who ran EKG test prescribed her with HBP medicine.

I have a mixed feeling right now. I’m happy that my mom has a chance to gain her right eye vision back, but at the same time can’t help being worried about the surgery. I’m also blank about this corneal transplant thing. Does anyone know about the procedure? Please keep us in your prayer and may God bless all eye donors wherever you are.

First, a five-year study run by Indiana University’s Kinsey Institute for Research in Sex, Gender, and Reproduction proves what many in the scientific community have always suspected: having children significantly lowers the IQ of both male and female parents.

Dr. Hosung Lee, director of the study, was not surprised with the findings. “The research proved that our hypothesis was correct. Having children does retard one’s brain activity, and since both parents lost intelligence, we must assume that this loss has a psychological rather than biological cause.”

The IQ tests show that when a child is born, the part of the brain that makes one think objectively takes the biggest hit when it comes to losing brainpower. “This explains why every parent thinks their child is the smartest kid in class or the best athlete, even if that child is as dumb as a box of rocks or needs a calendar to time their forty-yard dash. People who before were intelligent and open-minded turn into raving lunatics who want to blame a teacher or coach every time their mediocre child fails,” said Lee.

Lee says the Kinsey Institute will continue to test the couples participating in the study to determine if the loss of intelligence is reversible once children grow up and leave the nest and if parents who continue having children lose even more intelligence.

Second, a recent study performed at the University of Richmond and Randolph-Macon College in Virginia illustrates that pregnancy brainpower actually doesn’t decline at all during pregnancy.

Neuroscientists examined the activities of pregnant mice, rats, and humans and found that all three showed significant increases in mental acuity and memory throughout pregnancy and after giving birth. Human subjects in the study showed increased brainpower. Specifically, the pregnant women showed:

* increased visual acuity
* improved sense of smell

Is this Improved Memory Permanent?
One of the most significant findings of this and other pregnancy and memory studies is that the added brainpower caused by pregnancy appears to be permanent. Increased memory retention and improved cognition appear to continue throughout motherhood; in fact, parenting only seems to contribute to a woman’s brain power, allowing her to become:

* increasingly motivated
* less fearful
* more empathetic
* better able to multitask and prioritize

What About Men?
Women aren’t the only ones who appear to benefit mentally from pregnancy and parenthood. Men also appear to show increased mental performance, however, this occurs on a much lower scale than it does in women. In particular, men seem to show an increased ability to empathize with others. This is believed to be the result of an increase in estrogen and prolactin that occurs in men just prior to labor and delivery.

While the first finding already been discussed at my office since years ago, nobody ever mention about the second one. This issue was brought to the surface again lately as the company tried to change the company’s policy regarding female employees. The proposed policy will limit the number of employees allowed to be pregnant each year!

I was so upset when I heard this. I was even more upset when I heard that the policy was proposed by our HR manager whom is a woman, a 45 years old divorcee with no kids. I feel like wanting to slap her face whenever I meet her.

Anyway, which study do you want to believe?

My mom was at a good condition so there was no pre-treatment before the injection. Unlike when she had lucentis injection, her blood pressure was high at the time and took almost 4 hours for the anesthetic just to lower it. This time her blood pressure reading was 130/80 which was considered “normal” in my mom’s case. At 10:30 AM she was already released from OR.

On Saturday morning, the next day, we came back to the hospital for checkup. Her ophthalmologist said so far the IVT worked fine. The increase of intraocular pressure (IOP) as the side effect of IVT didn’t occur on my mom’s eye. Her tonometry test result showed 11 mmHg which still in the normal range of IOP.

She was scheduled to have another checkup on Thursday morning to see the progress. Hope everything would turn out fine.

I don’t understand why all of a sudden she got stomach ache that night. She didn’t eat anything unusual during the day. My brother said she probably just nervous for getting the injection the next day. He could be right. Hopefully, she can make it tomorrow.

The doctor said there was a swelling around my mom’s eye as a sign of Cystoid Macular Edema (CME) so he sent her to CDC room to get an OCT (Optical Coherence Tomography) test to make sure. However, somehow they couldn’t perform the OCT test so the doctor used ultrasound instead. Here’s the result.

His doctor then proposed an Intravitreal triamcinolone (IVT) injection as treatment to reduce the edema. He explained several possible causes of CME and the side effects of IVT. He also recommended some further tests to find out the exact cause of my mom’s macular edema such as hematology and TORCH test, thorax x-ray and dental checkup (in case she has tooth cavity).

The injection is scheduled on Wednesday at 2PM but we have to be there by 1PM as we will have further discussion about the procedure. Hopefully the IVT procedure can help to improve her vision.

The hospital, Jakarta Eye Center, is about 30 km away from our house and easy to be reached by train since both our house and the hospital are located near the train station. However, during bad weather like this, traveling by train is not a good option. There will be many delays or even cancellations. We tried to wait until the weather was good, but it never happened, it got worse instead.

So yesterday I forced myself to drive her to the hospital under heavy rain. My mom actually didn’t like the idea of me driving in rain, and to tell you the truth I didn’t like it either, but we couldn’t delay it any longer since she ran out of her artificial tear (Hialid 0.1) and started to feel burning sensation in her eye so she needed to get a new prescription.

Anyway, despite all the troubles we went through during our drive to the hospital, we heard good news from her ophthalmologist yesterday. He said my mom’s AMD treatment was showing a great result and her eye was already back and stable to its initial condition (which was after the glaucoma and cataract surgery), praise God. So the doctor changed her monthly check-up into every three month. Her next appointment was set on the first week of February next year, unless she felt something uncommon in her vision or her eye then she needed to see him immediately.

She also got a new prescription for her artificial tear and it’s copy until the next three months. Her ophthalmologist advised her to slowly reduce her Hialid 0.1 dosage from 6 times a day (current dosage) to whatever level she feels comfortable. His recommendation was to reduce it gradually until only three times a day but it depends on my mom’s eye reaction. That’s a really good news for us and we’re so happy to hear them!

Thankfully, after seeing my mom’s tonometri result yesterday, he said my mom’s eye has responded well to the injection, so no need to do the second injection. Her vision was already stable at 30/100. Her eye condition post glaucoma surgery was also good, with IOP (intraocular pressure) around 9-12 mmHg. So now my mom can continue her life without worrying too much about her eye condition, but her eye still need to be checked-up every month.

A 36D hand-held illuminated magnifier for my mom

After the appointment, her doctor sent my mom to Low Vision department to find a reading aid for her. Ever since she got AMD disease, my mom’s reading ability has dropped significantly. She could not read her Bible anymore as the letters were too small. This has become her main concerns as, for her, Bible was her source of life. She used to read it regularly every morning and for the last few months she was not able to do it. Her doctor said she needed a low vision aid to read small print.

After testing several lenses on her, the optician at the low vision department recommended a hand-held illuminated 9X (36 Diopters) power magnifier with built in LED light as her reading aid. It was actually not an ideal type for reading book as its lens size was only 35 mm so she could only read few letters at a time. But my mom said the most important thing was she could read her Bible again. She would need time to adjust with her new reading aid.

This is her OCT result before treatment (notice the abnormal blood vessel in the white circle):

This one is her OCT result after treatment:

We have to wait another 4 weeks to see the maximum effectiveness of the treatment. After that he will see if she needs another injection.

AMD is a degenerative condition of the Retina in which the central portion of the Retina, called the Macula, is damaged as a result of the hardening of the small arteries supplying oxygen and nutrients to the Retinal tissue. It is reported as the leading cause of blindness in people over 50 years of age.

When my mom was diagnosed with AMD last month, her ophthalmologist offered two types of drugs for her treatment, lucentis and avastin. Lucentis costs Rp 11 million (US$ 1100) while avastin costs Rp 2 million (US$ 200). The big cost difference between two drugs made us think twice before we decided which type of injection we should choose. The doctor said, “If money is not the problem, use lucentis as it’s already world-wide approved for AMD treatment.” Even though many eye-doctor use avastin as cheaper alternative for AMD treatment, the drug was initially developed (and later approved by FDA) for colon cancer, not for AMD. But he also reminded us that it’s going to be a long run treatment, and he couldn’t tell how many times my mom need the injection. It will depend on the each injection result that will be evaluated every two months.

I wish I could say “money is not the problem”, but sadly, I can’t. Money can become a problem if every two months my mom must have lucentis injection. Though my mom has her own money to support herself, she doesn’t have insurance. For years her medical was paid by my dad’s company, but after my dad died two years ago no more medical support for her. And it was too late for her to apply for new medical insurance at that time as she already 69 years old.

My brother and I can’t help that much either. I don’t know about other families but for us here in Indonesia US$ 1100 is a lot of money, it’s almost a month of my salary. However, after discussing it with my brother we agreed to proceed with lucentis for her first treatment. We just wanted the best for her whenever we could afford. Her doctor said it’s still ok to change to avastin for later treatment “if money finally become the problem”.

After seeing her OCT (optical coherence tomography) test, the ophthalmologist said she had an AMD (Age-related Macular Degeneration) disease and had to be treated with avastin or lucentis injection. The difference? Avastin costs $200 while Lucentis costs $1100. I don’t have time to check further deep about those drugs yet, when I agreed to have a lucentis injection for my mom. Hopefully I will get more information before the procedure tomorrow.